CPR Changes

Yes, I know this is a blog devoted to concussions, however as an athletic trainer it is our job to educate the public about, well, pretty much anything associated with injuries in sports.  With the increased attention on heart issues in sports, with some unfortunate deaths recently, I feel it necessary to disseminate this information.

The American Heart Association is instituting changes to the way CPR is taught and performed.  For the most part, these changes and clarifications were made to make it easier for anyone caught in an unfortunate situation of cardiac arrest.  A lot of this was discussed back in October, as it was highlighted on various media outlets.  As of April 1, these changes will be in effect for all instructors (yours truly included), meaning the way you once knew CPR is changing.

The basic premise is “Quality Compressions: at correct depth with full recoil and at a rate of 100 beats per minute.” So for those of us that are trained what does this mean?

Here is my Cliff’s Notes version (there are other changes/clarifications but not as vital as the following):

  • A-B-C (airway-breathing-circulation) is out and we now will follow C-A-B
    • Rather than delay compressions, the most important part of a cardiac incident, if someone is unconscious or has a witnessed arrest the first-responder should check for a pulse (no longer than 10 seconds)
    • Upon determining there is no pulse, compressions begin IMMEDIATELY
      • Rate of 100 bpm
      • Depth of 2″
      • Cycles of 30:2 continue, but now begin with compressions
  • “Hands Only” CPR
    • Is acceptable for laypersons or those that are not proficient/confident or feel unsafe giving rescue breathing
    • Rate continues to be 100 bpm
      • “Push hard and fast with complete recoil in center of chest”
  • Removal of “look-listen-feel” when dealing with airway and breathing
    • After compressions have begun rescue breathing should be immediate, initiated with a head-tilt-chin-lift or jaw thrust, no more observing or determining if there is breathing

The above changes were made to reduce “hands-off” time and increase the amount of compressions over time.  The other aspect is that the latent time when using A-B-C and L-L-F was detrimental to survival and could have been a barrier for bystanders performing resuscitation efforts.  The adult compression to ventilation is the same, as are the child and infant from the previous update in 2007.

Not changed but continued to be emphasized was the need for early defibrillation, as this has become a key component to survival.  Most public gathering spots now have AED’s, and their use is almost automated allowing even the most untrained person to use this device.  As it relates to current events, it is unknown if AED’s were used in any of the cases.

As mentioned there are other changes and points that the new guidelines provide, so the suggestion should be to get re-certified as soon as you can.  And rather than wait the principal two-years for renewal, a yearly update may be good to stay on top of the new process.  The AHA has plenty of exhaustive research to back up the changes, but it is really a common sense approach; lessening the down time and allowing anyone to perform chest compressions is a benefit.